EFFECTIVENESS OF SWL FOR LOWER-POLE CALICEAL NEPHROLITHIASIS - EVALUATION OF 452 CASES

The authors report on the treatment of lower-pole caliceal nephrolithi asis with extracorporeal shockwave lithotripsy (SWL) using the Czech-m ade Medilit M-5 lithotripter, In 310 patients, they have performed 452 treatments and evaluated the results 3 months after the last session using plain radiographs and ultrasound examination, The effectiveness of treatment and the success rate of SWL decreased with increasing siz e of stones: with stones >20 mm, it declined to 30%. This poor success rate was attributable not only to the size of the concrement, but als o to its location in a lower calix, which is unfavorable for the passa ge of fragments, For big lower-pole caliceal stones (>20 mm in the lon gest diameter), the authors recommend percutaneous nephrolithotomy as the primary management method, the effectiveness of which does not dep end on the size of the stone, The success rate achieved in treating th e lower-pole caliceal lithiasis using the Medilit M-5 machine was 61.3 %, similar to that achieved with other lithotripters.